Medtech M&A in 2026 Favors Strategic Options as Stryker Puts $400M Into CMR Surgical

Medtech M&A in September and October 2026 leaned toward strategic options instead of full acquisitions.

Stryker put roughly $400 million into CMR Surgical with an option to buy it. J&J sold Laminar to a new company formed by its original investor and team, and Olympus backed MaxQ Medical.

Henry Peck of LSI and I broke down all of it on this month's episode of The State of MedTech.

Key Takeaways

• Stryker announced a roughly $400M preferred equity investment in CMR Surgical, with an exclusive option to acquire the company and exclusive US sales rights for Versius.
• J&J sold the Laminar left atrial appendage program, which it bought for about $400M upfront in 2023, to Jaguar LAA, a new company formed by Santé Ventures and the Laminar team.
• Enovis made a binding offer for eCential Robotics at about $180M, within a couple of percentage points of Zimmer Biomet's $177M Monogram price in July 2025.
• Olympus Innovation Ventures was among the lead investors in MaxQ Medical's $31.5M Series A.
• Henry Peck said 77% of LSI Europe companies from 2024 onward plan an FDA-first path, and only about 14% name CE mark or MDR first.
• DaVita invested in Xeltis and Cochlear invested in Precisis, which Henry cited as strategics getting involved earlier.

Watch the full episode on YouTube

Why Do Strategics Take an Option Instead of Acquiring a Medtech Company?

Strategics take an option to see how the market develops before paying for the whole company, as Stryker did with a roughly $400 million preferred equity investment in CMR Surgical, the company behind the Versius robot.

The deal gives Stryker an exclusive option to acquire all of CMR and makes it the exclusive US sales agent for Versius.

Stryker's announcement says CMR keeps development and commercialization outside the US. CMR also reportedly explored a sale at up to $4 billion in 2025, so Stryker took a different route to the same company.

I interviewed Henry Peck, Chief Business Officer at LSI (Life Science Intelligence), on this month's episode of The State of MedTech. Henry described the playbook this way:

"Invest, distribute, learn, then decide."

Henry said Stryker's US commercial machine is the draw here. That means the hospital relationships, the reps, the field service, and the surgeon training.

I covered the structure on the same episode:

"Rather than paying billions of dollars up front, it can help commercialize the technology, see how the US market develops, and potentially acquire the company once more of that commercial risk has been removed."

Stryker's Mako acquisition pulled implant revenue through the robot. Henry doesn't think the Mako playbook will transfer. He said Versius competes on utilization and OR economics against Intuitive, Medtronic, and J&J.

Can a Medtech Acquisition Be Reversed?

Yes. J&J sold the Laminar left atrial appendage closure program to Jaguar LAA, roughly three years after buying Laminar for about $400 million upfront. Jaguar is a new company formed by Santé Ventures and the Laminar team, and financial terms weren't disclosed.

The pivotal study had been suspended. I said on the episode that Watchman's growth has slowed considerably, which changed the market J&J bought into.

Henry called the deal a true buyback. Santé was Laminar's earliest investor, and the same people who ran Laminar now run Jaguar.

Henry said:

"Basically, J&J sold them an option that they just didn't want to exercise, and Santé basically bought it back, on the cheap, with the people who wrote it."

Terms weren't disclosed, so "on the cheap" is Henry's read. His broader point was that J&J decided Laminar wasn't worth fixing inside J&J.

He also pointed to J&J's sale of NeuWave Medical to Quantum Surgical earlier this year as a precedent. And he noted the category isn't abandoned, with Gore and Conformal still active.

My read is that an asset that doesn't fit inside a large strategic can become valuable to a smaller, focused company. The medtech serial acquirer strategy works from the same logic in reverse.

Why Are Orthopedic Companies Buying Surgical Robotics Startups?

They want to protect implant revenue. Enovis made a binding offer for the French surgical robotics company eCential Robotics at an upfront enterprise value of €155 million, about $180 million.

That's within a couple of percentage points of the $177 million equity value Zimmer Biomet agreed to pay for Monogram Technologies.

MedTech Dive reports up to €35 million in additional milestones. Enovis expects to close by year-end after the French works council process.

I noted on the episode that eCential had built robotic technology for other orthopedic companies, including J&J's VELYS Spine platform. Enovis is buying a supplier its competitors already use.

On the same episode, Henry Peck put it this way:

"If one thing is clear about orthopedic robotics at this point, the robot really isn't the product. The implant revenue that it's protecting is the product."

Henry also said an independent orthopedic robotics company has a narrow path. He expects those companies to be acquired, sign an exclusive strategic partnership, or narrow their ambitions.

Stryker's installed base of roughly 3,000 Mako systems, a figure Henry and I both cited, shows how far ahead the leaders are. I broke down the wider pattern in surgical robotics M&A.

Why Do Strategics Invest Before a Medical Device Acquisition Happens?

Strategics increasingly show up as investors, distributors, and development partners before they show up as acquirers. Olympus Innovation Ventures was among the lead investors in MaxQ Medical's $31.5 million Series A, and Henry pointed to DaVita in Xeltis and Cochlear in Precisis.

Olympus already sells in urology, and MaxQ is building a prostate imaging and therapy system. So the investment gives Olympus a look at the next generation without a buyout.

DaVita Venture Group joined Xeltis's 2023 financing round. Xeltis is building a vascular access conduit for hemodialysis, and DaVita runs dialysis centers.

Henry cited Xeltis's European pivotal readout. He said it covered 120 patients across 22 sites in nine countries, with 79% secondary patency and a 3% access infection rate versus 9% for grafts and 22% for catheters.

Henry said strategics want to collaborate early:

"The appetite to collaborate with strategics in risk-on market environment has never been greater."

He added that the IPO market in medtech isn't a big consideration right now. I wrote about that market in my medtech IPO breakdown.

Are European Medtech Startups Planning for the FDA First?

Yes, more of them are. Henry said that among companies presenting at LSI Europe from 2024 onward, 77% had an FDA-first pathway, and only about 14% named CE mark or MDR first.

That data came from coding every pitch that companies gave on LSI's stages. Henry said the standout companies at LSI Europe 2026 had traction in Europe first and the FDA second.

Precisis, based in Heidelberg, has had a CE mark since 2022, according to Henry. He said the company has passed 150 implants and has FDA breakthrough device designation.

Positrigo, based in Zurich, received FDA 510(k) clearance in July 2024 for its compact brain PET scanner. Henry said it now has an install at an independent neurology practice in Southern California.

Both companies are early commercial and now coming to the US, with their traction in Europe first.

What Do Strategic Options and Early Investments Mean for Medtech Founders?

The first strategic at your door may offer an investment, a distribution agreement, or an option instead of a buyout. In my experience working with medtech founders, the picture of an exit is usually a full acquisition.

Each one asks the same question. Is the market real enough that the commercial risk is already coming down?

On the episode I said investors and strategics want a great business, and a great product is only part of that. Market engineering builds the evidence that a company is one.

A defined category, a clear market narrative, and visible traction give a strategic something to underwrite. Without them, even strong technology gets read as one more product.

If you're planning an exit, start with how to exit your medtech company and how to build a medtech company for acquisition.

Frequently Asked Questions

How is medtech M&A changing in 2026?

Strategics are using options, minority investments, and distribution agreements to get close to a company before committing to a full acquisition. Stryker's $400 million CMR Surgical investment is the clearest example from September and October 2026.

Full acquisitions still happen. Enovis made a binding offer for eCential Robotics at €155 million upfront, so the options sit alongside buyouts instead of replacing them.

Why did Stryker invest in CMR Surgical instead of acquiring it?

The structure lets Stryker add Versius to its US sales channel and watch how the robot performs before it pays for the whole company. That keeps the commercial risk lower while Stryker learns the market.

Stryker gets an exclusive option to acquire CMR and exclusive US sales rights. CMR reportedly explored a sale at up to $4 billion in 2025.

Why did J&J sell Laminar to Jaguar LAA?

J&J bought Laminar for about $400 million upfront in 2023. The pivotal study was later suspended, and Watchman's growth slowed, which changed the market J&J had bought into.

Henry Peck said J&J decided the asset wasn't worth fixing inside J&J. Santé Ventures and the Laminar team now run it as Jaguar LAA, and financial terms weren't disclosed.

What do strategic investors look for in an early-stage medtech company?

They look for evidence that the commercial opportunity is real. DaVita's investment in Xeltis and Cochlear's investment in Precisis are examples of strategics backing companies close to their own markets.

I said on the episode that strategics want commercially ready businesses, and a strong product alone doesn't show that. Clinical data, traction, and a clear category do.

How Do You Get a Medtech Company Ready for a Strategic Investor or Acquirer?

If you're doing this yourself. Start with the Exit Positioning Score. It shows how exit-ready your company looks to an acquirer today.

If you want it engineered with you. MarketCraft takes on a small number of medtech teams each quarter, starting with The Market Engineering Audit. If a strategic is going to weigh your company as an option, the audit shows what they'll see.

Listen to Henry Peck's Full Conversation

Henry Peck's full conversation with Omar Khateeb is available on The State of MedTech. Watch on YouTube. Subscribe wherever you listen to podcasts.

About Henry Peck

Henry Peck is Chief Business Officer at LSI (Life Science Intelligence). LSI runs the LSI medtech summits and the Compass AI platform for medtech market data. He joins Omar each month for the This Month in MedTech episodes of The State of MedTech.

About the Author

Omar Khateeb is the founder of MarketCraft and host of The State of MedTech, the number one podcast in the medtech industry. He works with medtech founders and commercial leaders on market engineering, commercialisation strategy, and revenue growth.

Visit marketcraft.ai or subscribe to The State of MedTech for weekly conversations with the people building the future of medical devices.